A point-blank Mexican stand-off between two bright red sofas adjudicated by a television. In the world of Feng Shui, this is quite a low score.
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Ventricular Tachycardia (V-Tach)
Ventricular Tachycardia is a dysrhythmia that usually originates from a single site within the ventricles at a rate greater than 100 bpm. The QRS complex is wide, bizarre and >0.12 seconds. As the heart rate increases, the ventricles do not have the opportunity to completely empty and refill. Therefore, cardiac output is decreased and adequate amounts of blood are not circulated to vital organs. Once the heart rate exceeds 160 impulses per minute, there is usually no effective pumping action of the heart and the patient presents with PULSELESS V-Tach. This patient requires immediate defibrillation. It is possible to have a pulse with V-Tach, however this will degrade into a life threatening dysrhythmia if left untreated.
Ventricular Fibrillation (V-Fib)
With V-Fib there are many impulses initiated from many locations within the ventricles. As a result the cardiac output is nonexistent and the patient will not have a pulse. The fibrillation may be fine or course waves. As the amplitude of fibrillation waves decreases so does the chance of successful defibrillation and reorganization of a viable perfusing rhythm.
Had a baby go into V fib in the cath lab off shift. Scariest code I’ve ever been involved in; but after a few joules and a pull through for a cardiac defect; he did just fine.
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